1. The Female Reproductive System-________ and ________ ______ ___ ____, or ______, and ________ them to the ____ of __________ -________ a ________ __________ for the ___________ and _______ of the ________ -________ ______ ___ ________ Uterus Ovary Uterine (Fallopian) tube Urinary bladder Symphysis pubis Urethra Clitoris Labium minus Labium majus Vaginal orifice Fimbriae Rectouterine pouch Fornix Cervix Rectum Vagina Anus producesmaintainsfemalesex cellsoocytestransports sitefertilization providesfavorableenvironment developmentdelivery offspring producesfemalesexhormones

2. I. Ovaries The Female Reproductive System -_______ ______ ___ ______ -_______ in the _____ ________, _______ to ____ ______ to the _____ ____, _____ to the _____ ______ ____, ____ in _____ by the _____ ________, the ______ _______, and the _________ _______, which also _____ ______ _____ ______ and ______ Ovary Suspensory ligament (with blood vessels and nerves) Broad ligament Ovarian ligament primaryfemalesexorgans developlowerabdomendescendjust inferiorpelvicbrimattachlateralpelvic wallheldplacebroadligamentovarian ligamentsuspensoryligamenthouses ovarianbloodvesselsnerves

3. I. Ovaries -_____ _______ ____ of _________ _____A. Tunica albuginea -structure B. Medulla-________ _____ _______ _____ and ________ ______ and ______ C. Cortex-_____ _____ _________ ______ of ____ called _______ _______, each of which ______ ___ _______ ______; about _______ _______ _______ at _______ 1. Oogenesis-the _______ of ___, or ____ Primary oocyte 2n=46 Meiosis I Reduction division Secondary oocyte n n Meiosis II Mitotic division Second polar bodies (die) Fertilization n First polar body n=23 n Ovum (egg) n n 2n=46 Zygote Begins in early development, then stops, resumes at puberty densecoveringlayerconnectivetissue innermostlayerhousingbloodlymphatic vesselsnerves outerlayercontainingmassescells ovarianfolliclesincludeoneprimary oocyte400,000primaryfolliclespuberty creationovaeggs

4. I. Ovaries C. Cortex 1. Oogenesis During synapsis of homologous chromosomes during Prophase I, crossing over occurs, resulting in new genetic variation

5. I. Ovaries C. Cortex 1. Oogenesis R x – Genetic Disorder-___________ ______, like those that _____ _____ _________, are much _____ _____ to _____ from the ___, because each ___ is _______ ___, and has had so much ____ to be _______ to ________, ______, and ______ that _____ _______ to _____ -_____ ____ ______ can _____ a ______ to _____ an ___ that does ___ ____ a ____ in ______whose ________ is ___________ for _______ _______; as in __________ (____) or ________ ________ ________ (_____) or _____-___ _______ (___); if the ___________ with the _______-_______ ____, which is ______ with __________ or ___________ is _______ in the ____ _____ ____, it ____ in the ________ ______, and that ________ ______ is _______ for ________ __________ Secondary oocyte First polar body chromosomedefectscauseDown Syndromemorelikelyresult egg decadesold timeexposedradiation virusestoxinscausedamageDNA polarbodybiopsyallowcoupleselect eggnotcarrygenewomen genotypeheterozygousgeneticdisorder hemophiliaXHXhXHXh DuchenneMuscular DystrophyXMXmXMXm SicklecellDiseaseS’S chromosomediseasecausinggene markedradioactivityfluorescence detectedfirstpolarbodyisn’t secondaryoocytesecondaryoocyte selectedin vitrofertilization

6. I. Ovaries C. Cortex 2. Follicle Maturation-______ _______ ___________, each of the __ _______ _______ _______ is __________ by a _____ of ____ called a _________ ______ duringprenataldevelopment 1millionprimaryoocytes surroundedlayercells primordialfollicle Primordial follicles

7. I. Ovaries C. Cortex 2. Follicle Maturation Primary oocyte Maturing follicle Primordial follicles -at the _____ of _______, _______- __________ ________ _______ by the _______ ________ _____ _________ the _______ _______ to begin ________ in ______ of about ___ at a time onset pubertyFollicle StimulatingHormonereleased anteriorpituitarygland stimulates400,000follicles maturinggroups 20

8. I. Ovaries C. Cortex 2. Follicle Maturation-____ of these _________ _______ ________ the ______, and, while the other _______ _________, goes on to ____ a ______ ______ Mature follicle onesecondaryfollicles outgrowsothers follicles degenerate formmaturefollicle

9. I. Ovaries C. Cortex 2. Follicle Maturation Theca externa Theca interna -the ________ ________ ______ ____ with _____ until, after _____ ____, it _______ a ____ of __ ___ in _______ and ______ out the ____ of the ______ Granulosa cells Fluid-filled antrum Corona radiata Zona pellucida Secondary ooctye maturingdominantfolliclefills fluid10-14days reachessize1cmdiameter bulges wall ovary

10. I. Ovaries C. Cortex 2. Follicle Maturation Theca externa Theca interna -_________ of the ____ of the ______ ______ ______ through the _____ of ___________ called the ____ ________ to _______ ________ for the _________ ______ Granulosa cells Fluid-filled antrum Corona radiata Zona pellucida Secondary oocyte processescellsCorona radiataextendlayer glycoproteinZona pellucidaprovidenutrition secondaryoocyte

11. I. Ovaries C. Cortex 3. Ovulation-finally _______ ____ ________ from ______ the ______ and _______ with the _______ _______ of the ___________ cause the ______ to _______, ________ the _________ ______ and some of its ___________ ____ into the _____ ______ -__ of __ ______ will at some time __________ ____ called ____________ (__________) at the ________ of _________, usually _______ from a ____ _______ to a ____ _____, but sometimes ______ up to a ____ ____, and __________ from ____ ____ to the _____ from _____ to ______ Infundibulum Secondary oocyte Ovary growingfluidpressurewithin folliclecontact waving fimbriae infundibulum folliclerupturereleasingsecondary oocytesurroundingcells body cavity 15womenexperience painmittelschmerzmiddle pain momentovulationlasting fewminutes fewhours lasting fewdays alternatingonesideother month

12. I. Ovaries C. Cortex 3. Ovulation-as ________ _____, the _______ of the ___________ become ________ with _____, to _______ its _______ of _________ the ______ Primordial follicles Primary follicle Secondary follicle Dominant follicle Mature (Graafian) follicle Ovulation First polar body Secondary oocyte Zona pellucida Corona radiata Infundibulum Fimbria Uterine tube Corpus luteum Corpus albicans ovulationnears fimbriae infundibulumengorgedblood increasechances“catching”oocyte

13. I. Ovaries 4. Corpus luteum C. Cortex -_______ _____ -after ________, _______ to ______ _____ _______ of ___________, which _________ the ___________ in the ______ ______ to _______ more _______ and ________ to _____ a ________ ___________ for ____________of the _______, if ___________ takes place -_______ ___________ and ________, which ________ ______ the _______ of _______-___________ ________ (____) and (___) __________ _________ (_____________) and _______ the ____________ of more ________ “yellowbody” ovulation remains secretelarge amounts progesterone stimulatesendometrium uterineliningbecomevascular glandularcreatefavorable environmentdevelopment embryofertilization releases progesteroneestrogen togetherinhibit release FollicleStimulating Hormone FSH LHLuteinizingHormone gonadotropinsprevent developmentfollicles

14. I. Ovaries 5. Corpus albicans C. Cortex -the _______ of the _______ ______ after it __________ and is _______ with ____ _____, after __________ does not _____ Corpus albicans remnantCorpusluteum degenerates replacedscar tissuefertilizationoccur

15. II. Uterine (Fallopian) Tube-_________ for the _______ _________ ______ _____ between the ______ and the ______ _____ -____ of __________ -_____ with ____, which ____ _______ the ______ to _____ a ______ which _____ the _____ into the ___________ and along with ________ __________ of the ____ of the ____, ______ the ______ and the _______ _______ the ______ Uterine horns Uterine tube Infundibulum passagwayovulatedsecondary oocytelyingovaries uterinehorns sitefertilization linedcilia beat towards uteruscreatecurrent drawsoocyteinfundibulum peristaltic contractions wall tubepropel oocyte embryo towards uterus

16. III. Uterus-_______ the ______ that ________ from a ________ ___ and _______ its ___________ -____ of ___________ of the ______ Uterine horns Uterine tube Infundibulum Fundis Body Cervix Cervical orifice Endometrium Myometrium Perimetrium A. Endometrium-_____ _____ of _______ __________ -_______ in ________ to _______ _______ by _________ ____ of the __________ ______ 1. Proliferative phase -_____ ________ ______ of ________ during _________ ________ to _____ ______ and _____ during ________ receivesembryo develops fertilized eggsustainsdevelopment site implantationembryo formsmaternal portionplacenta pregnancy contracts expel menses fetus delivery inner layermucousmembranes thickens responseestrogen secretedgranulosacells developingfollicle

17. III. Uterus Uterine horns Uterine tube Infundibulum Fundis Body Cervix Cervical orifice Endometrium Myometrium Perimetrium A. Endometrium -_______ _____ _______ and _________ in ________ to ___________ _______ by the ______ ______ 2. Secretory phase -________ and _______ ________, _____, __________, and _____ ________ to ______ an ___________ ________ for _________ ____________ becomesmorevascularglandular responseprogesteronesecreted corpusluteum produces secretesglycogen lipids electrolytesother nutrients createenvironmentfavorable embryonicdevelopment

18. III. Uterus Uterine horns Uterine tube Infundibulum Fundis Body Cervix Cervical orifice Endometrium Myometrium Perimetrium A. Endometrium -if ______ ______ ______ to _______, the ____________ of ___________ and _______ ____, causing _____ ______ in ___________ to ________, _________ _____ ____ and ______; _____ ______ __________ and ______ away, and, along with _____ from ______ _________, _____ ________ ____ 3. Menstruationcorpusluteumceasesfunction concentrationsprogesterone estrogen dropbloodvessels endometriumconstrictrestricting bloodflowoxygendyingtissues disintegrateslough blood brokencapillariescreate menstrualflow

19. III. Uterus 1. Low concentration of estrogen and progesterone allow pituitary to become unhibited, increasing the release of FSH and LH. 3. Increased release of FSH stimulates a new follicle to develop. 5.The developing follicle secretes increasing levels of estrogen 7. Increased levels of estrogen stimulate proliferative phase in uterus, endometrium thickens Proliferative phase

20. III. Uterus 10. Increasing levels of progesterone and estrogen inhibit release of FSH and LH by pituitary. 12. Hypothalamus stimulates pituitary to release LH, causing the follicle to rupture, triggering ovulation. 15. Increased levels of progesterone and estrogen released by corpus luteum after ovulation stimulate secretory phase in uterus, and inhibit secretion of FSH and LH by anterior pituitary gland Proliferative phaseSecretory phase

21. III. Uterus 1. Low blood supply to tissues of endometrium cause tissues to die and slough away, leading to the formation of the menses 28. Degeneration of the corpus luteum causes decreases in estrogen and progesterone, leading to blood vessel constriction in the endometrium of the uterus 24. Fertilization must take place during a 72 hour window between Day 12-14. If it doesn’t, the corpus luteum begins to degenerate around Day 24 Proliferative phaseMenstruationSecretory phase

22. IV. Vagina Uterine horns Uterine tube Infundibulum Fundis Body Cervix Cervical orifice Endometrium Myometrium Perimetrium -______ _________ _____; receives _____ during ______ __________ Vagina -__________ for the ______ and other _________ of the ______ -____ as the _____ _____ lying _______ the ______ of the ______ and the _____ -________ from ________ by the __________ _______ ____________ ___, which _______ ______ _________ by the ____ of the ______ into _____ ____, ___ = __ female copulatory organpenis sexualintercourse passagewaymensessecretions uterus actsbirthcanal betweencervix uterus vulva protectedinfectionmutualisticbacteria Lactobacillussp.ferment lactoseproduced cellsvaginalacticacidpH 5

23. IV. Vagina-_______ ______ further ________ and ______ ___ by the ______, a ____ _________ with a _____ ______ ________ to allow _______ and _______ _________ to ____ _______; often _______ ________ of ________ -______ _______ ______ around its _____ _______ which _______ to ______ __________ by becoming ________ with _____, causing the ______ to _______ and ________ Anus Perineum Vaginal orifice Urethral orifice Clitoris Mons pubis Labium majus vaginalorificeprotectedclosedoff hymenthinmembranesmallcentral openinguterinevaginalsecretions passoutsideculturalindicatorvirginity houses erectiletissuesouteropening respondsexualstimulation engorgedbloodvagina expand elongate

24. Anus Perineum Vaginal orifice Urethral orifice Clitoris Mons pubis Labium majus V. Vulva-_______ ______ ________ -________ which _________ _____ ________ of ____ the _______ and the ______ A. Labium majus-______ ____ of the _____ IV. Vagina-just _____ to ______ ______, ______ of the _____ _____ of ______ become ________ with _____ to ________ _______ on the _____ and _______ _____ ______ prior female orgasmtissuesouter thirdvaginaengorgedblood increasefrictionpenis trigger male orgasm externalfemalegenitalia structuresurroundsouteropeningsboth urethravagina largerlips vulva

25. V. Vulva A. Labium majus -_________ by ________ ____, which _______ the _______ and _______ ______ -_______ and ______ the _____ _______ ___________ ______ -_______ on the _______ with _____ ____, _________ ______, and ________ ______ ______, which ______ ____ _______ of _____ as part of the ______ ________ Anus Perineum Vaginal orifice Urethral orifice Clitoris Mons pubis Labium majus Pudendal cleft Vestibule Labium minus enclose protectotherexternal reproductive organs separatedpudendalcleftincludes urethralvaginalorifices coveredoutside pubichair sebaceousglands apocrine sweat glandssecretehighvolumessweat sexualresponse

26. V. Vulva B. Labium minus-_______, _____ ____ of the _____ -_______ the ________ and ______ _________ to ____ a _________ ________ for the ______ C. Clitoris-_________ ________ to the _____, only __ ___ long -contains ______ _______ that become ________ with _____ in ________ to ______ __________ -has _____ on _______ ___, containing ______ ___________ _____ _______ D. Vestibule-_____ ________ by the _____ _______ containing ______ and _______ _______ -_________ (_________) ______ ______ into ________ on either ____ of the _______ ______, ________ ______ into _________ to _______ __________ for ______ ___________ -contain _______ of _______ _______ on either side called _________ _____ smallerinnerlipsvulva enclosevestibule mergeanteriorly formhood-likecoveringclitoris structuredsimilarlypenis2cm erectiletissuesengorged bloodresponsesexualstimulation glans anterior endhighly concentratednerveendings space enclosedlabiaminora vaginalurethralorifices vestibular Bartholin’sglandsempty vestibulesidevaginalorifice secretingmucusvestibule provide lubricationsexualintercourse masseserectiletissues vestibular bulbs

27. VI. Mammary Glands-_______ in ______ and _______, _________ to ________ in ________ by ________ ________ by ______ at the _____ of _______ -each ______ __________ of ______ ______, which _______ ________ _______ Pectoralis minor Pectoralis major Alveolar glands -________ _______ ______ into _________ ______, which ______ into __________ ______, which _____ to the _______ through the _______ Ampulla Lactiferous duct Alveolar duct Nipple Areola Alveolar duct Ampulla similarmalesfemalesstimulated developfemalesestrogen secretedovariesonsetpuberty breastcomposed15-20lobes containalveolarglands alveolarglandsemptyalveolar ductsdrainlactiferous ductsopenoutside nipple

28. VI. Mammary Glands-during _______, ______ and _____ _______, become ___________ with _______ tissue Pectoralis minor Pectoralis major Adipose tissue Alveolar glands Ampulla Lactiferous duct Alveolar duct Nipple Areola Alveolar duct Ampulla -during __________, _________ _________, ____________, and ________ _________ _______ to ________ _______, ________ _________ in _____ and _________ _______ _______ with _________ _______, _____ __________ __________ by _________ is _________ until after _____ by _____ ______ of _________ and ____________ pubertyglandsductsenlarge surroundedadipose pregnancyplacentalestrogen progesteronelactogenstimulate breastsdevelopfurtherpossibly doublingsizereplacingadipose tissueglandulartissuemilk productionstimulatedprolactin inhibitedbirthhighlevels estrogenprogesterone

29. VI. Mammary Glands R x – Breast Cancer-_____ ________ _______ among _______ after _____ _______, with ________ ____ ______ and _______ _______ _____ _____ in the _____; __ in ____ _______ in the _____ will get ______ ______ at ______ _____ during their _____, ______ ________ has ________ _____ of ______ _______ in the ______, ________ ______ of _______ ______ among ________, _____ ____ of ______ ________ are in _____ Tumor mostcommoncancerwomen skincancer178,000newcases 40,000deathseachyearU.S.1 13womenU.S.breastcancer somelifeNorth Americahighestratebreastcancer worldleadingcausecancer deathwomenonly1%breast cancersmen time

30. VI. Mammary Glands R x – Breast Cancer -_______ _______ by an _________ _________ -_______ by ____________ (________ of ______) or ___________ (________ of ______) and __________ ______________ ______ ______, _________ by _________ and _____________ -__________ by ______ _________, _______ _____- ______ and ______ _____________ for _______ over ___, _________ _____ _______; ____, ______ _______, and __________ being _______ (_______- __________ _________) Tumor 5-10%causedinheritedtendency treatedlumpectomyremovaltumor mastectomyremovalbreast sometimesaccompanyinglymphnodes followedradiationchemotherapy preventedearlydetectionbreastself examyearlymammogramswomen 40knowingriskfactorsagefamily historyespeciallyfemalegrowth triggeringhormones

31. The Female Reproductive System R x – Uterine Cancer-_____ _________ _______ of the _______ ____________ _____, with about _______ ____ ______ and _____ _______ _____ ____ in the ____ -_____ _______ _______ are ___________ ___________, with _____ _______ _________ (______ of the ____________) -_____ ________ _____ -______ _______ by ____________ (________ _________ of the ______), often with ____ _______ and _______ ______, __________ ____________ by ________ and _____________ R x – Amenorrhea/Oligomenorrhea-_________ _________ or __________ __________ _____ ____ to ________ _________ _______ -______ ________ to _____ _______ ________ with ____ _____ ____ mostcommoncancerfemale reproductivetract39,000new cases7400deathseachyearU.S. mostuterinecancersendometrial carcinomassomeuterinesarcomas cancermyometrium 84%survivalrate oftentreatedhysterectomysurgical excisionuterusbothovaries uterinetubessometimesaccompanied radiationchemotherapy completestoppagediminished menstrualflowduereduced estrogenlevels morecommon In 1968 15 year-old Cathy Rigby became the first American gymnast to medal in international competition. In “a sport that demands absolute control, both emotionally and physically”, she also suffered from an eating disorder. http://home.earthlink.net/~durangodave/html/writing/Rigby-Yoculan.htm elitefemale athleteslowbodyfat

32. R x – Amenorrhea/Oligomenorrhea -_______ __________ _____ ____ in _______ _________ ______ _______ _________ to _______ a __________ -___________ ____ ________ ______ in _________ _________ of the _________ ______ by _______ ____, which _____ to __________ _______ of _______-___________ _________ by the ________ ________, ________ to _________ ________ ___________ and ________ ________ _________, ________ to _________ __________ of ____________ during __________ ______ in _______ -_______ _______ of ________ __________ _______ __________ of ____ in _______, ______, ________, and ______ _____ Olympic diver and Bulimia nervosa sufferer Kumiko Soldati. "It would be hard to find a female athlete in the aesthetic sports — gymnastics, diving, cheerleading, figure skating, dancing — who isn't preoccupied with body image and somewhat obsessive about what she is eating”. http://www.usatoday.com/news/health/2006-02-05-women-health-cover_x.htm higherlevelsestrogen stimulatesgreaterdeposition fatbreaststhighsbuttocks underskin higherpercentagebodyfat womencontainscaloriereserve requiredsustainpregnancy diminishedfatreservesresult decreasedsecretion hormoneleptinadiposecells leadsdecreasedsecretion FollicleStimulatingHormone anteriorpituitaryleading decreasedfollicledevelopment decreasedestrogenproduction leadingdecreasedthickening endometriumproliferative phaseuterus

33. R x – Amenorrhea/Oligomenorrhea-can also be _______ by _______ _________, __________ _________ ________ Very thin fashion models portrayed by media as “what it is to be sexy”, ironically more likely to be “sexless” due to decreased libido linked to diminished estrogen secretion because of decreased fat reserves http://www.maryelise.com/modernwoman_eatingdisorder_models.JPG causedeating disordersespeciallyAnorexia nervosa

34. R x – Ovarian Cancer-___-_____ common ______ among ______, ___- ______ cause of _____ _____ among ______, causing ______ ____ _____ each ____ in the ____, and ______ ______ per ____ in the ____ -____ ______ include ___ (____ of _______ ______ _____ in ______ over ___), ______, and ______ ______ (__ in ___ _______ _______ ______ to a _______ in _______ that can be _____ for) -______ most _____ with _______ _______ (____________) in which ___ or ____ _______ are ________, sometimes _____ with the ______ _____ and the ______, followed by ____________ -__ out of ___ ______ ______ for _____ _______ ______ will ____ more than ____ _____ after ________, but _____ _________ is ________, because _________ are ______ 9 th mostcancerwomen5 th leadingcancerdeath women 22,000 newcases yearU.S. 15,000deathsyearU.S. riskfactorsage67%ovariancancers occurwomen55obesityfamily history110ovariancancerslinked changegeneticstested treatedoftensurgicalexcision oophorectomyonebothovaries removedalonguterinetubes uteruschemotherapy 910womentreatedearlyovarian cancerlivefiveyears detectionearly detectiondifficult symptomsvague

35. R x – Premenstrual Syndrome (PMS)-affects ____ (________) of ________ women sometime during their ____ or so ________ cycles -affects only ________ women, not ________ or ______________ women -thought to be caused by _________ _________ causing _________ of ________ and ____________; too much ________ or too little ___________ -thought to _____, and be ______ by ________ amounts of the ________ ______________ ________, which causes the _____ ______ to become __________, causing a woman to “____________” _______ Hysterectomy-the surgical removal of the uterus Hysterics-a fit of uncontrollable laughter or crying Hysteria-from the former notion that hysterical women were suffering from disturbances of the womb 80%40 million American 400menstrual ovulating pregnantpost-menopausal imperfect ovulationimbalance estrogenprogesterone estrogen progesterone causecaused decreasedinhibitory neurotransmitterserotonin limbicsystem uninhibited feel too muchemotion

36. R x – Premenstrual Syndrome (PMS)-________ symptoms include ________, ________, _____ ________, __________, ________ ______, ______, ________, _____ __________, and __________ -____________ symptoms include _________, _________, ______, ___________, ______, ____ of ___________, decreased _____ -__________ _________ is a much ______ form of ____ linked to ________ changes after _______ -______ with ___________ to ____ (____ in ____, ___ in ___, ______, _______, ____, _______, and ______), _______ (_______ _____ of _________), __________ like ______, ___________ therapy physical headachejoint painfluid retentionconstipationabdominal crampsfatiguebackacheheart palpitationsweight gain psychological irritabilitydepressionanxiety panic attackstensionlack coordinationlibido post-partumdepression deeperPMS hormonedelivery treatedmodificationsdiet highfiberlowsaltsugars starchesfatscaffeine alcoholexerciseincrease releaseendorphinstranquilizers Valiumprogesterone http://www.kartoen.be/cartoons/happysad/pms.gif

37. The Reproductive Systems R x – Sexually Transmitted Diseases 1. Chlamydia-caused by the ________ ____________________ -__________ by ______, ____, or ____ ___, can be __________ to an ______ ____ from its _______ ______ during _________ -______ an estimated _________ in the ____ each ____, but only __________ _____ are _______ -____ of ______ and ____ of ____ _______ show __ _________, _________ ______ in ___ ______ after ________ -_________ include _______ _________ during ________ and ________ ________ from _____ or ______, leads to ______ ___________ _______ (___) in ______ when left ________ in ____ of _____, can lead to ______ -______ with _________ bacteriumChlamydia trachomatis transmittedvaginalanaloralsex transmittedunbornbabyinfected motherpregnancy infects2.8 millionU.S. year0.9 millioncasesreported 75%women50%meninfectedno symptoms appear1-3weeks exposure symptomsburningsensation urinationabnormaldischargepenis vaginapelvicinflammatorydisease PIDwomenuntreated40% casessterility treatedantibiotics

38. R x – Sexually Transmitted Diseases 2. Gonorrhea-______ by _________ ___________________ -_______ ____ _____ each ____ in the ____ with about ____ being ________ -__________ by ______ with _____, ______, ______, or ____ of _______ ______, and from a ______ to her ____ as it ______ through the _____ _____ -_________ in ____ include _______ ________ while ________, ________ (___) from the _______, and ______ and _______ ________ -_________ in ______ may include ______ ________ while ________, increased ______ ________, and ________ between ________ ______, but ____ ______ show __ _________, or _________ are ____- _______ and ________ for _________ ____ -can lead to ____ and _______ in ______ -______ with _________, which is getting more difficult due to the emergence of drug-resistant strains causedbacteriumNeisseria gonorrhoeae 700,000newcasesyearU.S. halfreported transmittedcontactpenisvaginamouth anusinfectedpersonmother babypassesbirthcanal symptomsmenburningsensation urinatingdischargepusurethra painfulswollentesticles symptomswomenburningsensation urinatingvaginaldischarge bleedingmenstrualperiodsmost womennosymptoms non specificmistakensomethingelse PIDsterilitywomen treatedantibiotics

39. R x – Sexually Transmitted Diseases 3. Genital Herpes-caused by the ______ _______ __ _____ -_________ people (____) in the ____ over age __ have been _______, more common in ______ than in ____ -_________ include _____, _______ ______ _____, and other _______ _________, and the ________ _________ of ______ ______ ______ -__________ by ______ _______, only ______ from _______ ______ to ______ ____, but ________ can be ______ to ____ -___ necessarily ________ through use of _______, which may ___ _____ all _________ _____ -__ ____, ______ with ________, which _______ _________ of _____ _____ and ________ the ____ (_____) _____ HerpesSimplexIIvirus 45 million20%U.S. 12infectedwomen men transmittedsexualcontactrarely infectedmotherunbornbaby infectiondeadlybaby symptomsfeverswollenlymph nodesflu-likesymptoms recurrentappearancepainfulgenitallesions notprevented condom Blister-like Herpes lesions Classic Symptoms in Men Classic Symptoms in Women http://www.famvir.com/info/tools/toolsprivate/resources/photos.jsp notcoverinfectious areas nocuretreatedAcyclovirprevents replicationviralDNAshortens lyticactivephase

40. R x – Sexually Transmitted Diseases 4. Genital Warts-______ by the ______ _________ _____ (____) -about _________ currently _______ in the ____, with about __________ ____ _____ each ____, ____ of all _______ _____ ______ have had ________ at some point, by ___ ___, ____ of all ______ in the ____ will have had an ________ -_________ include _____ __ or ______ the ______ _____, but ____ _______ ______ ____ ___ _________ and _____ _____ they have it -_____ can be _______ _________ or _________ -can sometimes _______ ___ of _______ ______ -can be _________ by __________ of ________, which _______ against the ____ _____ of ____ which _____ ____ of ________ _______ and ____ of ______ _____ causedHumanPapillomaVirusHPV 20 millioninfectedU.S. 6.2 millionnewcasesyear 50%sexuallyactiveadults infectionage5080% womenU.S.infection symptomswartsonaround genitalareamostinfectedpeopleshow nosymptomsdon’tknow wartsremovedsurgicallychemically increaseriskcervicalcancer preventedvaccinationGardasil ® protectsfourtypesHPV cause70%cervicalcancers 90%genitalwarts Penile Genital Warts http://herpes-coldsores.com/std/genital_warts_pictures.htm#Penile%20Genital%20Herpes%20(HPV)%20Pictures

41. R x – Sexually Transmitted Diseases 5. Syphilis-______ by the ________ __________________ -__________ by ______ with ____ ____ called _______ -_____ ______ with _________, if ____ ________ ________ to ________ and ______ ______ _________ by ____ _______ of ______, ________ by ________ of ______ called _______ on the ______ _____, ________ the _____ and _____, _______ to ________ and _____ -thought to have been the _____ of _____ of ____ _____ ____, who had ___ _____ and _____ _____ 6. AIDS-________ ________________ _________, ______ by the ______ ________________ _____ (___) -__ to __ _____ _____ ______ to ______ _____ if _______ with _______ ____, ______ _______ ______ of _____ for ____, ________ draw ____ ____ _____ (___________ and ___________) to ________ to _____ off ________ -has ______ ________ ____ in ____, ____ ____ have ____ causedbacteriumTreponema pallidum transmittedcontactopensorechancre easilytreatedantibioticsleftuntreated progressessecondarytertiarysyphilispunctuated longintervalslatencyfollowedformation lesionsgummasinternalorgansincluding brainnervesleadingdementiadeath causedeathKingHenry VIIIsixwivesmanylovers AcquiredImmunodeficiencySyndromecaused HumanImmunodeficiencyVirusHIV 25timesmorelikelyacquireAIDSinfected anotherSTDlesionsprovideportalsentry HIVinfectionsHIVhostcellslymphocytes macrophagesgenitaliafightinfection caused1 millioncasesU.S.overhalfdied King Henry VIII